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da Cunha JA, Marques Dos Santos M, Costa de Lima K. Acquired syphilis in older people in Brazil from 2010-2020. PLoS One 2024; 19:e0296481. [PMID: 39240879 PMCID: PMC11379233 DOI: 10.1371/journal.pone.0296481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 12/14/2023] [Indexed: 09/08/2024] Open
Abstract
BACKGROUND The infection caused by Treponema pallidum remains a severe public health problem, with a high prevalence in individuals over 60 years. However, research into infections such as syphilis continues to be neglected in geriatrics. This study aims to evaluate data on the detection rate of syphilis in Brazil, in individuals between 60 and 120 years, by characterizing the epidemiological profile and respective factors associated with it, in addition to performing a temporal trend analysis, from 2010 to 2020. METHODOLOGY Ecological, time-series study, which started with the collection of notifications from the database of the Information System on Compulsory Notification of Diseases. The epidemiological profile was characterized based on sociodemographic variables. The Statistical Package for the Social Sciences program, version 19.0, was used for incidence and prevalence analysis. The 2010 census by the Brazilian Institute of Geography and Statistics and projections for older people were considered. In the trend analysis, the Joinpoint regression model was used. MAIN FINDINGS There was an upward variation in the detection of syphilis in older people from 2010 to 2018, with a peak in 2018. In 2019, there was a slight reduction in the notification of cases, which was accentuated in 2020. The prevalence of the infection was equivalent to 12.84 cases for each 100,000 Brazilians, with a mean age of 68.04 years (±7.15) for those between 60 and 120 years, being higher in white and black males. The highest proportion of older people with syphilis occurred in the South and Southeast regions. However, the trend analysis showed a significant and homogeneous increase in all regions of Brazil, for both sexes and all age groups. CONCLUSIONS There is a tendency for an increase in cases of syphilis in older people, which reinforces the need to plan health actions to combat the disease in this population.
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Affiliation(s)
- Josiane Araújo da Cunha
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Marquiony Marques Dos Santos
- Laboratory of Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Kenio Costa de Lima
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Graduate Program in Collective Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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França APFDM, de Sousa CM, de Lima MSGA, Fonseca RRDS, Laurentino RV, Monteiro JC, Feitosa RNM, dos Santos LM, Oliveira-Filho AB, Machado LFA. High Prevalence of Syphilis among Young Pregnant Women in the Brazilian Amazon: A Cross-Sectional Study Based on Clinical Records in a Public Health Reference Unit in the City of Belém. Pathogens 2024; 13:686. [PMID: 39204286 PMCID: PMC11357224 DOI: 10.3390/pathogens13080686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/20/2024] [Accepted: 08/12/2024] [Indexed: 09/03/2024] Open
Abstract
BACKGROUND Syphilis remains a significant global public health concern, and one of its consequences in pregnant women is the potential occurrence of congenital syphilis due to Treponema pallidum infection. This study determined the prevalence of syphilis among pregnant women undergoing prenatal care in a neighborhood on the outskirts of the city of Belém, Brazilian Amazon. METHODS This cross-sectional study used data from clinical records of 611 pregnant women who underwent prenatal care at a public health unit in 2019 and 2020. The reagent result for VDRL was used as an indicator of syphilis. Odds Ratio and chi-square tests were used to evaluate the association of information from pregnant women with syphilis. RESULTS The overall prevalence of syphilis was 5.2 % (32/611; 95 % CI: 3.5-7.0 %). Age under 23 years was identified as a risk factor for syphilis. CONCLUSIONS The prevalence of syphilis among pregnant women in the outskirts of Belém is high, especially among younger women. There is an urgent need to intensify innovative sexual and reproductive health education initiatives and emphasize the importance of consistent practice of preventive measures against syphilis and other STIs in the Amazon region, especially in the young population.
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Affiliation(s)
- Ana Paula Figueiredo de Montalvão França
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém 66075-110, PA, Brazil; (A.P.F.d.M.F.); (C.M.d.S.); (M.S.G.A.d.L.)
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (R.R.d.S.F.); (R.V.L.); (J.C.M.); (R.N.M.F.)
| | - Camille Massena de Sousa
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém 66075-110, PA, Brazil; (A.P.F.d.M.F.); (C.M.d.S.); (M.S.G.A.d.L.)
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (R.R.d.S.F.); (R.V.L.); (J.C.M.); (R.N.M.F.)
| | - Misma Suely Gonçalves Araújo de Lima
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém 66075-110, PA, Brazil; (A.P.F.d.M.F.); (C.M.d.S.); (M.S.G.A.d.L.)
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (R.R.d.S.F.); (R.V.L.); (J.C.M.); (R.N.M.F.)
| | - Ricardo Roberto de Souza Fonseca
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (R.R.d.S.F.); (R.V.L.); (J.C.M.); (R.N.M.F.)
| | - Rogério Valois Laurentino
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (R.R.d.S.F.); (R.V.L.); (J.C.M.); (R.N.M.F.)
| | - Jacqueline Cortinhas Monteiro
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (R.R.d.S.F.); (R.V.L.); (J.C.M.); (R.N.M.F.)
| | - Rosimar Neris Mantins Feitosa
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (R.R.d.S.F.); (R.V.L.); (J.C.M.); (R.N.M.F.)
| | - Leonardo Miranda dos Santos
- Bacteriology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil;
| | - Aldemir Branco Oliveira-Filho
- Study and Research Group on Vulnerable Populations, Institute for Coastal Studies, Federal University of Pará, Bragança 68600-000, PA, Brazil;
| | - Luiz Fernando Almeida Machado
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém 66075-110, PA, Brazil; (A.P.F.d.M.F.); (C.M.d.S.); (M.S.G.A.d.L.)
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (R.R.d.S.F.); (R.V.L.); (J.C.M.); (R.N.M.F.)
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Dantas JDC, Marinho CDSR, Pinheiro YT, Ferreira MÂF, da Silva RAR. Temporal trend and factors associated with spatial distribution of congenital syphilis in Brazil: An ecological study. Front Pediatr 2023; 11:1109271. [PMID: 37033177 PMCID: PMC10075361 DOI: 10.3389/fped.2023.1109271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/03/2023] [Indexed: 04/11/2023] Open
Abstract
Objective The study aimed to analyze the temporal trend of congenital syphilis in Brazil in the period from 2008 to 2018 and its spatial distribution in the Immediate Regions of Urban Articulation, and to identify spatial correlations with socioeconomic factors and prenatal care. Methods Spatial correlations between the incidence of congenital syphilis and socioeconomic conditions and access to prenatal care were assessed. This ecological study conducted a time series analysis in Brazil and spatial analysis in 482 Immediate Regions of Urban Articulation. Cases of congenital syphilis reported in the Notifiable Diseases Information System and the Live Birth Information System from January 1, 2008, to December 31, 2018 were included. Socioeconomic conditions (percentage of individuals with inadequate water supply and sanitation) were extracted from the 2010 census, whereas the Live Birth Information System provided data on access to prenatal care (percentage of live births with 1-3 prenatal care appointments). The Joinpoint Regression software performed the temporal trend analysis, while the GeoDa software assessed territorial clusters using the Moran's I and Local Spatial Association Indicator. Results The incidence of congenital syphilis showed an upward trend (annual percent change 1 = 26.96; 95% CI: 18.2-36.3; annual percent change 2 = 10.25; 95% CI: 2.7-28.4) and was unevenly distributed across Immediate Regions of Urban Articulation in Brazil (Moran's I = 0.264, p ≤ 0.05). It also presented a direct spatial correlation with the percentage of individuals with inadequate water supply and sanitation (Moran's I = 0.02, p ≤ 0.05) and the percentage of live births with 1-3 prenatal care appointments (Moran's I = 0.03, p ≤ 0.05). Conclusion Agrowth trend of congenital syphilis in Brazil was observed between 2008 and 2018. Moreover, inequalities in socioeconomic conditions and access to prenatal care influenced the spatial distribution of this disease.
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Affiliation(s)
- Janmilli da Costa Dantas
- Graduate Program in Collective Health, Health Science Center, Federal University of Rio Grande Do Norte, Natal, Brazil
- Correspondence: Janmilli da Costa Dantas
| | - Cristiane da Silva Ramos Marinho
- Graduate Program in Collective Health, Faculty of Health Sciences of Trairi, Federal University of Rio Grande Do Norte, Santa Cruz, Brazil
| | - Yago Tavares Pinheiro
- Graduate Program in Collective Health, Health Science Center, Federal University of Rio Grande Do Norte, Natal, Brazil
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Dantas JDC, Marinho CDSR, Pinheiro YT, da Silva RAR. Temporal Trend of Gestational Syphilis between 2008 and 2018 in Brazil: Association with Socioeconomic and Health Care Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16456. [PMID: 36554342 PMCID: PMC9778377 DOI: 10.3390/ijerph192416456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/22/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
The increased number of cases in recent years has turned syphilis into a global public health problem. In 2020, 115,371 cases of acquired syphilis were reported (detection rate of 54.5 cases/100,000 inhabitants) in Brazil. In that same period, the country notified 61,441 cases of gestational syphilis (detection rate of 21.6 per 1000 live births). The number of syphilis cases points to the need to reinforce surveillance, prevention, and infection control actions, which is a worrying scenario for government organizations. This study aims to describe the temporal trend of gestational syphilis from 2008 to 2018 in Brazilian regions and to associate its detection rate with socioeconomic and health care indicators. We conducted an ecological study of temporal trends using secondary data from the Department of Informatics of the Unified Health System. The temporal trend was analyzed using the Joinpoint Regression program. The annual percent change (APC) and 95% confidence intervals (95%CI) were estimated and tested; statistical significance was assessed using the Monte Carlo permutation test. Correlations were assessed using Pearson's correlation coefficient, and statistical significance was calculated using Pearson's product-moment correlation. The gestational syphilis detection rate increased between 2008 and 2018. The South region showed the greatest trend, whereas the Midwest region presented the lowest trend. The following variables were significantly correlated with the gestational syphilis detection rate: Municipal Human Development Index, illiteracy rate, percentage of primary health care coverage, and proportion of doctors, nurses, and basic health units per inhabitant. Health policies are needed to mitigate social vulnerabilities and strengthen primary health care.
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Affiliation(s)
- Janmilli da Costa Dantas
- Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal 59064-630, Brazil
| | | | - Yago Tavares Pinheiro
- Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal 59064-630, Brazil
| | - Richardson Augusto Rosendo da Silva
- Postgraduate Program in Public Health, Federal University of Rio Grande do Norte, Natal 59064-630, Brazil
- Center of Health Sciences, Department of Nursing, Federal University of Rio Grande do Norte, Natal 59078-900, Brazil
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de Andrade BAB, de Arruda JAA, Gilligan G, Piemonte E, Panico R, Molina Ávila I, Pimentel Sola JM, Carmona Lorduy MC, Pupo Marrugo S, Sánchez Tatis AS, Werner LC, Abrahão AC, Agostini M, Buoro L, Israel MS, Freire NDA, Lima LA, Abrantes TDC, Cunha JLS, Pérez-de-Oliveira ME, Roza ALOC, Vargas PA, Lopes MA, Santos-Silva AR, de Almeida OP, Pontes FSC, Pontes HAR, Rondanelli BM, Villarroel-Dorrego M, Bologna-Molina R, Derderian N, Sánchez-Romero C, Abreu LG, Fonseca FP, Mesquita RA, Gomez RS, Martínez-Flores R, Delgado-Azañero W, Alves ATNN, Lourenço SDQC, Coimbra C, Polignano GAC, Assunção Júnior JNR, Souto GR, Souza PEA, Horta MCR, González-Arriagada WA, Romañach MJ. Acquired oral syphilis: A multicenter study of 339 patients from South America. Oral Dis 2022; 28:1561-1572. [PMID: 34263964 DOI: 10.1111/odi.13963] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 07/01/2021] [Accepted: 07/11/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To report the clinicopathologic features of acquired oral syphilis cases in South American countries. MATERIALS AND METHODS Clinical data were retrospectively collected from the records of 18 oral diagnostic services in Argentina, Brazil, Chile, Colombia, Venezuela, Uruguay, and Peru. Serologies of nontreponemal and treponemal tests were used for diagnosis. RESULTS The series comprised 339 cases of acquired oral syphilis. Secondary syphilis ranked as the most common stage (86.7%). Lesions were more frequent among males (58.0%) and young adults with a mean age of 33.3 years. Individuals aged 20-29 years were most affected (35.3%). The most commonly involved sites were the tongue (31.6%), lip/labial commissure (25.1%), and hard/soft palate (20.4%). Clinically, acquired oral syphilis usually presented as mucous patches (28.4%), papules (25.7%), and ulcers (18.1%). Skin manifestations occurred in 67.7% of individuals, while lymphadenopathy and fever were observed in 61.3% and 11.6% of all subjects, respectively. Most patients were treated with the benzathine penicillin G antibiotic. CONCLUSION This report validates the spread of acquired oral syphilis infection among young adults in South America. Our directives include accessible diagnostic tools for proper disease screening, surveillance, and counselling of affected individuals, especially in low- and middle-income countries.
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Affiliation(s)
| | - José Alcides Almeida de Arruda
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Gerardo Gilligan
- Department of Oral Medicine, Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Eduardo Piemonte
- Department of Oral Medicine, Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - René Panico
- Department of Oral Medicine, Facultad de Odontología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | | | | | | | | | | | | | - Aline Corrêa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Michelle Agostini
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luisa Buoro
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mônica Simões Israel
- Department of Diagnosis and Therapeutics, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
- Postgraduate Program of Oral Medicine, Faculdade São Leopoldo Mandic, Rio de Janeiro, Brazil
| | | | - Lucas Ambrósio Lima
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Thamiris de Castro Abrantes
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - John Lennon Silva Cunha
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, Brazil
| | | | | | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, Brazil
| | - Marcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, Brazil
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, Brazil
| | - Oslei Paes de Almeida
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, Brazil
| | | | | | | | | | - Ronell Bologna-Molina
- Molecular Pathology Area, Faculty of Dentistry, Universidad de la República, Montevidéu, Uruguay
| | - Nathalie Derderian
- Molecular Pathology Area, Faculty of Dentistry, Universidad de la República, Montevidéu, Uruguay
| | - Celeste Sánchez-Romero
- Molecular Pathology Area, Faculty of Dentistry, Universidad de la República, Montevidéu, Uruguay
| | - Lucas Guimarães Abreu
- Department of Child's and Adolescent's Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - René Martínez-Flores
- Department of Oral Medicine and Oral Pathology, School of Dentistry, Universidad Andrés Bello, Viña del Mar, Chile
| | - Wilson Delgado-Azañero
- Department of Oral Pathology, Oral Medicine and Oral Surgery, School of Dentistry, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | | | | | | | | | - Giovanna Ribeiro Souto
- Graduate Program in Dentistry, School of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Brazil
| | - Paulo Eduardo Alencar Souza
- Graduate Program in Dentistry, School of Dentistry, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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